The Journal of Korea Assosiation for Disability and Oral Health (대한장애인치과학회지)

Korean Association for Disability and Oral Health (대한장애인치과학회)
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MULTIDISCIPLINARY APPROACH FOR THE DENTAL TREATMENT OF A PATIENT HAVING TRACHEOSTOMY TUBE

기관내삽관을 가진 장애환자의 치과치료를 위한 협의 진료

  • Cha, Yoon-Sun (Department of Pediatric Dentistry, Wonju Severance Christian Hospital, Wonju Medical College, Yonsei University) ;
  • Kim, Ji-Hun (Department of Pediatric Dentistry, Wonju Severance Christian Hospital, Wonju Medical College, Yonsei University)
  • 차윤선 (연세대학교 원주의과대학 원주세브란스기독병원 소아치과학교실) ;
  • 김지훈 (연세대학교 원주의과대학 원주세브란스기독병원 소아치과학교실)
  • Received : 2014.06.23
  • Accepted : 2014.06.26
  • Published : 2014.06.30
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Abstract

A tracheostomy tube serves as airway management for patients whose respiration is impeded due to inflammation, tumor, or traumatic events. If the patients who have tracheostomy tube, visit dental clinic for dental treatments, we should consider the underlying general condition of patients and then make treatment plans according to their state. A 22-Year old male patient, who had tracheostomy tube on his neck, came to our department for comprehensive dental treatment. Mild mental retardation was observed and he was taking anti-convulsant drugs for the prevention of epileptic seizure. Multiple advanced dental caries, hopeless teeth, and impacted third molars were also observed by clinical and radiographic examination. Due to the risk of epileptic seizure and low cooperativity to tolerate the treatment, general anesthesia was recommended by physician, and the anti-convulsant drug was administrated during procedure. In this case, we aimed to report the multidisciplinary approach for the dental treatment of patient having a tracheostomy tube.

본 증례에서는 특별한 주의가 필요한 장애인을 위한 효율적이고 전문적인 의료 전달을 위해 여러 과와의 협의를 통한 진료가 필요함을 알리고 있다. 특히 기관절개관을 가진 환자의 마취관리와 치과치료를 시행함에 있어서 전신상태 및 기관절개관에 대한 이해와 주의가 필요하다. 1. 충치치료를 주소로 내원한 22세 남환에서 기관내삽관의 활용을 통해 전신마취 하에서 치과치료를 성공적으로 전달하였다. 2. 환자는 발작의 위험성을 가지고 있었으며, 안전한 치과치료를 위해 전신마취를 행동조절의 방법으로 선택하였다. 3. 기관내삽관에는 여러 종류가 있으며, 그 중 전신마취 하에 호흡보조를 할 수 있는 종류는 커프를 가진, 이중내강의 형태로 된 관이다. 따라서, 기관내삽관을 가진 환자에서 전신마취 하 치과치료를 진행하기 위해서는 기관내삽관의 형태에 대한 적절한 평가 및 처치가 선행되어야 한다.

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References

  1. O'Connor MF, Ovassapian A : Chapter 35. Airway Management. In: Hall JB, Schmidt GA, Wood LDH, editors. Principles of Critical Care, 3e. New York, NY: The McGraw-Hill Companies, 2005.
  2. Wein RO, Chandra RK, Weber RS : Chapter 18. Disorders of the Head and Neck. In: Brunicardi FC, Andersen DK, Billiar TR, et al., editors. Schwartz's Principles of Surgery, 9e. New York, NY: The McGraw-Hill Companies, 2010.
  3. Patel MR, Cannon TY, Shores CG : Chapter 242. Complications of Airway Devices. In: Tintinalli JE, Stapczynski JS, Ma OJ, et al., editors. Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e. New York, NY: The McGraw-Hill Companies, 2011.
  4. Pohl Y, Filippi A, Geiger G, et al. : Dental treatment of handicapped patients using endotracheal anesthesia. Anesth Prog, 43(1):20-23, 1996.
  5. Karolyhazy K, Kovacs E, Kivovics P, et al. : Dental status and oral health of patients with epilepsy: an epidemiologic study. Epilepsia, 44(8):1103-1108, 2003. https://doi.org/10.1046/j.1528-1157.2003.04003.x
  6. Rosenberg M, Weaver J : General anesthesia. Anesth Prog, 38(4-5):172-186, 1991.
  7. Guideline on management of dental patients with special health care needs. Pediatr Dent, 34(5):160-165, 2012.
  8. Robbins MR : Dental management of special needs patients who have epilepsy. Dent Clin North Am, 53(2):295-309, ix, 2009. https://doi.org/10.1016/j.cden.2008.12.014
  9. Wang YC, Lin IH, Huang CH, et al. : Dental anesthesia for patients with special needs. Acta Anaesthesiol Taiwan, 50(3):122-125, 2012. https://doi.org/10.1016/j.aat.2012.08.009
  10. Malamed SF : Medical emergencies in the dental office. 5th edition ed. St. Louis (MO): Mosby, 2000.
  11. Durbin CG, Jr. : Indications for and timing of tracheostomy. Respir Care, 50(4):483-487, 2005.